Question 1

What is HCPCS code G9364?

Accepted Answer

HCPCS code G9364 is "Sinus caus bac inx". Sinusitis caused by, or presumed to be caused by, bacterial infection

Question 2

What category is G9364 in?

Accepted Answer

G9364 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9364?

Accepted Answer

Use G9364 when billing for sinus caus bac inx. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G9364 covered by Medicare?

Accepted Answer

Coverage for G9364 (Sinus caus bac inx) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G9364?

Accepted Answer

Documentation for G9364 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).